| NPI | 1114102571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN COOPER Director 817-267-6222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 5246) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX H9976) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2008-11-11 |